In meeting its regulatory commitments, the FDA can find itself increasingly at odds with pharma companies, which are under pressure to launch as many drugs as possible and to grow their businesses from sales of these products. As the new political administration, under President Barack Obama, has promised a new direction for US healthcare,1 it is inevitable that the FDA will undergo significant change. However, although the agency and pharma have often been at loggerheads, it is the criticism of the general public regarding failings in drug safety that will have a greater impact on the future of the FDA.
There is internal debate within the pharma industry concerning its productivity and innovation in R&D. Year by year, new drug output has steadily declined, despite continuing unmet medical need in a number of important disease areas. The global pharma industry continues to increase its investment in R&D — with an estimated spend of $70 billion (51.7 billion) in 20072 — but the performance of the sector in translating this investment into innovative products remains questionable. Critics of the pharma industry have argued that companies rely too heavily on line extensions and working on new formulations of existing products rather than concentrating their efforts on true innovation in R&D. This has led to companies submitting weaker regulatory dossiers, which in turn has restricted the number of drugs reaching the market.
Some companies have blamed regulatory agencies, such as the FDA, for the decline in new drugs on the market. In 2007, the FDA approved 65 original new drug applications (NDAs), the least since 1999.3 Furthermore, the ratio of NDAs approved to NDAs submitted has dropped from the 76% level of 2006 to less than 60%.4 Many companies believe that the FDA has been excessively bureaucratic, which has slowed the review process.5 One 2008 media report claimed that 15 additional new drugs could have been on the national market if the FDA had been more efficient in conducting its reviews.5 The FDA has a target of meeting 90% of its new drug approval timelines for review, but although full 2008 performance data have not yet been released, the agency has already indicated that it is unlikely to reach this goal.6
Despite these criticisms, the FDA insists it has not changed the way in which it approaches regulatory review. Recently, an agency spokesman stated that the rate of NDA approvals to submissions remained steady at approximately 80% from 1997 through to 20053 — although independent media reports have cited a decline after this period.4